Individual
JACQUELINE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
118 KRAUSE DR, JERSEYVILLE, IL 62052-3610
(618) 498-1808
(618) 462-2504
Mailing address
2615 EDWARDS ST, ALTON, IL 62002-3915
(618) 462-2331
(618) 462-2504
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/30/2014
Last updated
10/02/2014
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